The latest with my mother is that she is scheduled for a numbing injection in her back on December 29. Saw pain management, and he says there’s a lot of degeneration, old compression fractures, etc. He is going to do a two-part procedure, the first of which is a numbing injection, and if that works, she will get a nerve ablation at some later point not sure when. Y’all might recall that she’s been on 10 mg Norco since her cervical spine surgery in May. This is well past when the surgeon would give her medication. Her PCP volunteered to do it. This is when her thoracic spine started really hurting and doing PT for the cervical spine surgery. And before that, during our 10 years estrangement, and before that, she really had tendency towards taking too much of a variety of medication’s. Was found outside passed out and diagnosed with opioid abuse. The PCP cut her off from pain meds in June 2021, when he got in trouble. But now he readily prescribed them again. And to be fair, so far, I have not seen her this time over using them. I was just at her house and counted her pills and she has an appropriate number left.
So we’re finally going to get some pain management in the hopes that she can stop using opioids. I don’t have a lot of faith that this will actually stop her pain. I’ve been reading that these procedures are hit or miss and need to be repeated, etc. She won’t have the money to keep repeating them.
The current pressing problem is that due to the opioid shortage, I have not been able to locate a pharmacy to have them call her meds to. I have called 18 pharmacies within a 50 mile radius of where we live and nobody has the medication. So I guess we get to see what drug withdrawal looks like over the Christmas holiday on a 75-year-old person. She says she’d been through it before when they cut off her meds before, and she did not have withdrawal. But I don’t know if this is true, because I was not around her at that time. She could be telling me this because I noticed she tends to hide things from me, stating she does not want to worry me. So I hope she is well enough to undergo her procedure on the 29th so we can at least try to get some sort of remedy to this situation.
I’ve been asking her to conserve her pain, pills, gradually reduce usage given the difficulties we’ve been having in finding them the past couple of months. This is the first time I’ve been completely unable to find them. And of course she has refused.
The pain doctor did prescribe her Celebrex. As of yesterday evening, she had not yet tried it. It would be nice if the Celebrex actually worked and did not cause her any problems. But she already has IBS and I’m not convinced that it won’t mess up her stomach. As usual, with her, all of the options are bad.
I would contact her surgeon and PCP and ask them what to do if she starts having withdrawal symptoms (my guess would be take her to the ER).
Also, why are these procedures costing her? Does Medicare not cover them?
The awful thing with opioids is that they cause this cycling of pain which is rebound, and often caused by the addiction. Just reading a memoir by a guy who had shattered leg and pelvis with severe nerve damage, motorcycle accident. His leg withered and almost useless and pain excruciating. That despite opioid addiction. Started walking the Appalachian Trail with brace to cure himself of opioids and pain. He has so much in that book about the pain cycle and how opioids actually end up HURTING and CAUSNG pain through this habitual cycling in the brain.
Nothing like spinal compression and fractures for pain. My heart goes out to your Mom. I hope the procedures help. The withdrawal a whole other problem. Good news is that this author said the pain wasn't worse without the opioids when he stopped them. Book is Only When I Step On It by Peter Conti. I think free on Kindle, or at least cheap.
Found the book, free on Kindle.
Thank you, you are so helpful and knowledgeable.
Judicious use of Tylenol #3 has kept me upright and functioning well enough. I tapered off of 10 mg Norco years ago and really didn't feel like it was any more effective than the Tylenol #3.
Withholding pain meds is a tough call for Drs. They are really being scrutinized.
I hope your mom's back injections help. For some people they are worthless (me being one)..they're just the hoops we had to jump through before surgery could be approved.
Good for you for helping mom to be able to get her meds. I didn't know that pharmacies hold back pills for certain patients. Don't know how I feel about that.
I understand the 'opioid crisis'--but I also know that the biggest abusers of them are people in the medical field (this comes out of the mouth of a Dr. who knows. He said the biggest abusers were doctors themselves and patients were suffering for it.)
Pain meds have a place in our lives--used appropriately. I feel for anyone who has to have them or they simply can't function.
I take 1 Tramadol a day which the doctors are more willing to write prescriptions for than any other pain meds. It takes the edge off a bit. But not a lot more than 1 500mg Tylenol and 1 Advil together. And a heating pad and a back binder/brace when I plan to go out. And in my cupboard, btw, I have a bottle of morphine and oxycodone I don't take. My oncologist will write me a prescription for literally anything, no problem. Nothing works, in reality, for severe back issues and I do enjoy pooping so there's that too 🤣😂. Constipation is real with pain meds, but not with a Tramadol a day.
The trouble with addicts is they lie, hide, act secretive and will go to any lengths to get their drug of choice....at OUR expense. Do what you can for mom w/i reason, then detach with love. You have your own issues to deal with which ate no less real than her issues. It's fine to help her, on your terms, w/o getting TOO wrapped up in her problems. These women have a tendency to make THEIR problems into OUR problems and we wind up having difficulty separating them.
Is your mother taking 10 mg Norco a few times/day or just once/day? This may seem like a stupid question, but she may have more pain at a particular time of the day. If only once/day she is probably NOT physically dependent, and withdrawal may not be an issue if she does run out. You can read about managing Norco withdrawal at the site www.drugs.com, my go-to site for reliable online drug information. If you are trying to have her conserve medication, she could reduce the daily dose by cutting the pills in half and thus taking 5 mg instead of 10 each time she takes it. That could be less traumatic than cutting down the frequency of taking Norco. I'm assuming here that Norco pills, like Percocet, can safely be cut; check with the pharmacist.
The Celebrex should help cut the pain, but it will probably not cut the pain as much as the Norco does. One other short-term possibility, assuming Norco remains unavailable, would be to ask her physician to add Tramadol, a weak narcotic, to the Celebrex until Norco becomes available again. Tramadol may be available when stronger narcotics are not. Another possibility for neurogenic pain is pregabalin (brand name in the U.S.; Lyrica). It is often useful for severe pain (not for me, unfortunately), and it is not an opioid. I assume, also, that one of the goals of the surgery is to reduce the need for pain medication. Perhaps after the surgery and some recovery, a strong opioid, such as Norco, will not be needed.
The best of luck to you and her!